Richmond clinic uses gold star reward system to help its patients shed nearly four tons

Christopher Cousins | BDN

Christopher Cousins | BDN

Thomas Bartol, a nurse practitioner at Richmond Area Health Center, created the Star Program two years ago, which has helped some 400 patients at the clinic lose more than 7,800 pounds.

Richmond Area Health Center | BDN

Richmond Area Health Center | BDN

Richmond Area Health Center patient Theresa Foye has lost 50 pounds in five years thanks, in part, to the health centers community weight loss program where patients have lost a combined 7,800 pounds in two years.

RICHMOND, Maine — Sometimes the most complex problems have the simplest solutions.

Modeled after a time-tested method of encouraging children to study and behave in class, gold stars on the wall, the ringing of a bell and applause are powering an initiative at Richmond Area Health Center that has helped 400 patients lose nearly four tons of weight in the past two years. On Tuesday, the clinic celebrated the initiative by bringing in two horses to represent the 7,800 pounds lost by patients.

“When our patients lose weight, they get a gold star and we hang it on the wall,” said Tom Bartol, a nurse practitioner at the clinic in the Kennebec County town. “Then they ring a bell and everyone who’s around the clinic claps. A lot of times, I just see this wonderful face when they hear that clapping.”

Whether a patient has lost two pounds or 20, it’s a major milestone, said Bartol. Shedding even a couple of pounds in a month could result in the loss of more than 20 in a year, which for many of Bartol’s patients has resulted in the reduction or cancellation of medications for high blood pressure, cholesterol and diabetes. Part of the secret to the clinic’s success is a supportive attitude that stretches from receptionists in the lobby to doctors and nurse practitioners in exam rooms.

“It’s about building hope in our patients,” said Bartol. “Someone who’s obese doesn’t need to be told they’re obese. They know that. In the past, as health care providers, we’ve told people what to do and, in general, most of us don’t like to be told what to do.”

Dr. Sheila Pinette, director of the Maine Center for Disease Control, told a crowd gathered in Richmond Tuesday that despite a trend toward higher obesity rates that has led to one in four children and two out of three adults in Maine to be classified as obese, the success of programs such as this one is irrefutable.

“Through tremendous persistence and hard work I know that the patients themselves have had to put in a lot of effort and change the way they do things,” said Pinette, according to written remarks. “Through education, counseling and the support of their providers and the staff here, they have made a difference. … Prevention is the best and most cost-effective way to help turn these things around.”

Bartol, who created the Star Program in 2010, said he and other providers at the clinic typically extend a patient’s exam by five or 10 minutes for the sole purpose of discussing weight loss techniques — even if it’s only reducing their diets by 100 calories a day or adding a mere five minutes of exercise. The extra conversation time costs the clinic and its staff money — Bartol says he is paid according to how many patients he sees — but the trade-off is considerable. In a perfect world, doctors and patients would be rewarded financially for making progress.

“A heart bypass costs more than $100,000,” he said. “I could prevent three surgeries right here and I don’t get another cent.”

Theresa Foye of Pittston, who was diagnosed with type 2 diabetes in 2007, has lost 50 pounds since then, much of it as part of the Star Program, which at the very least has given her hope.